Monday, October 31, 2016

By Wesley SmithHere we go again. Having failed to convince Massachusetts voters to legalize assisted suicide in 2012, and having repeatedly failed to get such legislation passed, the former Hemlock Society now Compassion and Choices is bringing a lawsuit to declare that assisted suicide is a right because it isn’t suicide. From the WCBV story:

Two Cape Cod doctors are asking a Massachusetts court to rule that it’s not a criminal act for physicians to prescribe lethal doses of medication to mentally competent patients with terminal illnesses.

A lawsuit was filed Monday in Suffolk Superior Court by Dr. Roger Kligler, who has terminal cancer, and Dr. Alan Steinbach, with the help of Compassion & Choices, a Denver-based nonprofit that works on end-of-life choices. It also asks the court for an injunction to prevent criminal prosecution of what it calls “medical aid in dying,” which the group says is not the same as assisted suicide.

The group says in medical aid in dying, the patient controls the process from beginning to end. In assisted suicide and euthanasia, someone else’s actions and choices cause death.

What drivel. Euthanasia, where legal, is usually asked for by the person killed. Ditto assisted suicide. Besides, if being in “control of the process”–a false premise as the whole point is to have an MD validate the hastened death–somehow makes self-killing not suicide but something else, what does terminal illness have to do with it? I mean, what constitutional rights are so narrowly limited to a minority of people? This same gambit has failed before in Connecticut and New Mexico. But think about the attempted societal corruption! Typical of these zealots who want to expand the culture of death by whatever means necessary, including by euthanizing the integrity and meaning of language.More information on this topic:

By Paul Russell is the director of HOPE Australia.Dutch journalist, Gerbert van Loenen once observed about euthanasia in his homeland that, 'Making euthanasia and physician-assisted suicide legal started a development we did not foresee. The old limit ‘thou shalt not kill’ was abandoned, a new limit is yet to be found.'When we abandon the principle that the law (in this case the criminal code prohibitions on homicide) protects all of its citizens equally, as van Loenen observes, drawing a new line is arbitrary. More than that; it is likely to shift further in ways that perhaps the Dutch did not foresee but that we at least, can now reflect upon given their experiences.Not that we necessarily need to look halfway across the globe to observe the phenomenon.In South Australia only in this last week we saw that, notionally at least, something like half of the members of the House of Assembly seemed willing to support a bill that would have made euthanasia available to any adult who claimed that they were experiencing 'unbearable and hopeless suffering'.No, we do not have euthanasia on the statute books; so how, you ask, is this an example of van Loenen's thesis?South Australia has been the epicentre of euthanasia debate with something like 14 or 15 bills introduced over the last two decades - some of them simultaneously in both chambers. None of them have been as extreme as the bill mentioned. In hindsight, now that the bill seemingly will not progress further, the mover and the euthanasia lobby that supported it may now reflect that their project was overly ambitious; running well ahead of the zeitgeist.And so it was. What shocked me, however, was the level of support it did receive. Five or ten years ago such a regime would have been dismissed far more easily.The bill would have created a starting point for euthanasia similar to the Dutch law and almost identical to the Belgian statute. Yet the public discourse was largely framed around what we might call the 'classic cases' at the very end of life. Replete with personal stories, we were told, both implicitly and explicitly, that these were the kind of cases the bill was designed for. As with the Dutch law, according to van Loenen, there was a 'devil in the detail' in this bill that would provide for euthanasia in situations that the public could not forsee.The question we need to be asking, always, is not 'who is the bill designed for?' but 'what will the bill allow?'. There is clearly public support for the idea of euthanasia, as evidenced in the polls, but the detail seems to escape scrutiny.Purchase the Euthanasia Deception documentary and show it in your community.

Such was the campaigning strategy adopted by Andrew Denton, his campaign called 'Go Gentle' and his co-beligerents, the Australian Nursing and Midwifery Federation. They jointly created an on-line campaign tool called 'BetheBill' where people could register to 'BetheBill' using their social media profiles and the automated structure would replace the pronoun 'person' in the text of the failed bill with their own name and send a copy of the thus amended bill to every South Australian member of parliament.Nowhere does the 'BetheBill' website explain to the potential supporter that the bill in question would allow for euthanasia for any adult. All it says before a supporter clicks through to make it happen is: 'One day you, or someone you love, may be dying and want this choice. No Australian should be left to die in unrelievable pain.' It plays on the public perception that euthanasia would only ever be for a few 'hard cases'.And so, email in boxes of members of parliament were clogged, for sometime, with virtually identical emails from people who had no real idea of what they were supporting. That many of these 'BetheBill' supporters came from interstate or overseas or were from fake facebook profiles such as that of 'Desmond Tutu' (who apparently lives in Sydney and uses the profile picture of Bozo the Clown) registered a level of cynicism and annoyance with a number of MPs.In hindsight we cannot avoid the conclusion that all of this was over-reach; a misjudgement of the ability of parliamentarians to assess the true situation - even in the face of what seemed like a tsunami of public and media support.What it does tell us, very clearly, is that - regardless of whatever minimalist approach is presented for debate - what the movers really want is so much more.Victorian Health Minister, Jill Hennessy warned euthanasia supporters of this kind of over-reach behaviour recently in regards to what we are led to believe is the inevitable tabling of a euthanasia and/or assisted suicide bill in the Victorian Parliament sometime in the near future.Under the headline: Euthanasia reform: ‘Go softly or law will fail’, the Australian article framed the story this way:

'Victorian Health Minister Jill Hennessy has warned radical ­euthanasia activists that any proposed assisted-suicide laws will be moderate, to enable broad community support and avoid failure because of a scare campaign.

'Ms Hennessy said the Greens and the Sex Party should be ­“sensible and open-minded” if ­euthanasia laws were introduced to the Victorian parliament, ­imploring the minor parties not to scupper the reform on the pretence of ­policy purity.

“To not do so would be an act of revisionism designed to make an important first step fail; it is not about you,” Ms Hennessy said.

“Politicians need to ask themselves: is it about being pure or is it about saying ‘let’s get the best ­result we can’?”

But, once again, the euthanasia lobby cannot help itself; it cannot contain its enthusiasm in the wave of media support that has clouded the debate in Victoria as it has in South Australia.Recommendation 49 of the Victorian Parliamentary Committee Report on 'end-of-life choices' tabled in July calls for a law for people, “suffering from a serious and incurable condition which is causing enduring and unbearable suffering” and that these persons must be “at the end of life (final weeks or months of life)”.Dr Rodney Syme wrote recently to the Victorian Health Minister on behalf of the Victorian pro-euthanasia lobby, calling for an extension to these terms to include people who have an 'advanced incurable illness'; in otherwords, not simply those who are clearly close to dying.Syme's logic is internally consistent and compelling if, in fact, the aim of such legislation is to relieve suffering. It is not only those who are close to death who suffer. This is the same sort of argument put to the Belgian people regarding child euthanasia in 2013 and is the same argument circling in Holland at the moment in regards to proposals for child euthanasia and euthanasia for people who are 'tired if life'.But there's a significant difference between the Dutch and Belgian examples (above) and what Syme is presenting and what was presented in the bill in South Australia. The Dutch and the Belgians already have euthanasia on the statute books. Arguments for incremental extensions are easier to make once the beachhead is established.Returning to van Loenen's observations, it should be obvious to anyone that once we abandon the equal protection of the law for every citizen from acts of homicide and assisting in suicide; wherever we choose to draw the line next will not have the same holding force as the criminal code.We will have created exceptions that will later be tested by arguments such as those put by Syme; exceptions that will further erode the protection of the law, replacing it with the arbitrary decisions of individual doctors who, in effect, will become the law.

The Canadian euthanasia issue marks a time of upheaval in medical ethics and the healthcare system which could be compared to events a century ago in Russia.

The Bolsheviks were not preordained to take over from the previous government, but their ruthlessness and aggression were unmatched. They demonized competing ideas and purged the social structures. They made their own laws. Nothing was allowed to stand. All was justified for public good, the good of the Proletariat.

People who would be ignored if they insisted that all welfare recipients be required to think alike, or that all Canada Council grants be used to create the same work of art, grab attention by bullying Catholic caregivers and hospitals which, like all hospitals, could not survive without tax dollars.

Every day thousands of Canadian patients are humanely transferred between homes and hospitals. Some are seeking a procedure offered in a different building, for which an ambulance ride and a change in the wallpaper would not arouse comment in normal times.

But in August of this year, a Vancouver patient had an interval of poor pain control while he was being transferred from St. Paul's Hospital to be euthanized elsewhere. The lapse in medication was, ironically, triggered by the euthanasia consent process itself, followed by a pharmacy mix-up.

That provided a gotcha! moment for activists which was exploited to demand that all hospitals must now offer their premises for the use of doctors who want to euthanize patients on site. There are howls of outrage that St. Paul's, a Catholic hospital, is a euthanasia-free zone in keeping with its principles.

This indignant bluster is an attempt to ignore the caution and limitation that the Supreme Court and Parliament tried to place on euthanasia. The new law really just excuses police from charging a doctor with murder if stringent eligibility rules are rigorously followed.

This narrow exception allowed euthanasia in order to protect the right to life proclaimed in Section 7 of the Charter. That may seem bizarre, but the Court decided that having the eventual option of death at the hands of a doctor was likely to prevent earlier do-it-yourself suicides. Flimsy or not, that was the hinge of the Carter decision and for now we are stuck with it.

Taking a mere exception to a murder charge and spinning it as a right to be euthanized everywhere and anywhere in Canada is audacious but transparently political. The euthanasia lobby, flushed with its recent success, wants a monopoly on power, and a health care monoculture that sweeps away all opposition.

Inviting such extremism into our society would be, to say the least, unhealthy. True diversity and freedom would not be served by it. The activists now attacking Catholic hospitals would not stop there. Everything is a one-way street for them. Their Utopia is euthanasia on demand.

Having convinced themselves that they are the only true humanitarians, no compromises are possible. Like someone who wears far too much perfume, they can't understand why others would not want the common space pervaded by their own superior preferences.

The problem is not "religious hospitals." The problem is zealous ideologues whose inability to accommodate those outside their faction will damage the fabric of our culture.

Dr Will Johnston is a family physician in Vancouver and the Chair of the Euthanasia Prevention Coalition - BC.

Thursday, October 27, 2016

The suicide lobby have filed a case on behalf of two Cape Cod Massachusetts doctors in the Massachusetts Superior Court to give them the right in law to prescribe lethal drugs to assist the suicide of their patients.

The suit, which was filed in Massachusetts Superior Court, was filed by Compassion & Choices, a Denver-based nonprofit organization that advocates nationally for allowing doctors to assist patients in dying. The suit was filed on behalf of Dr. Roger M. Kligler, a resident of Falmouth, and Dr. Alan Steinbach, a resident of Woods Hole.

The suit seeks a declaration that assisted suicide, or "medical aid in dying," is not a crime by Massachusetts law. The suit also seeks an injunction protecting from prosecution doctors who provide medical aid in dying.

Dr. Kligler is currently in the late stages of prostate cancer. In a press release from Compassion & Choices released Wednesday, October 26, he argued for the right to medicate himself as needed, given his condition.

"Having a prescription for aid-in-dying medication that I could self-administer if my suffering became too great in the final days would provide great comfort to me," Dr. Kligler said.

In the same release, Dr. Steinbach voiced his desire to be able to discuss assisted suicide as an option with his patients and to assist his patients, as needed, without fear of prosecution from the state.

As shocking as it is that Elizabeth Wettlaufer, 49, of Woodstock; has been charged with 8 counts of first degree murder in what is being defined as possibly the worst case of a seriel killer in Canadian history, we need to demand that an in-depth investigation be done into every care home in Canada, especially now that euthanasia and assisted suicide are now legal.

We should mourn the deaths of James Silcox (84), Maurice (Moe) Granat (84), Helen Matheson (95), Gladys Millard (87), Mary Zurawinski (96), Helen Young (90). Maureen Pickering (79) of Woodstock Ontario and Arpad Horvath (75) who was a resident at Meadow Park nursing home in London, but we must also recognize that these are a group of many deaths caused by people who falsely consider themselves angels of mercy in our medical system.

As Executive Director of the Euthanasia Prevention Coalition, I have received calls from people who are convinced that their loved may have been prematurely killed in a hospital or nursing home. These cases are very frustrating because it is nearly impossible to prove that such an act has occurred and the financial and personal costs associated with gaining justice is prohibitive.

Monday, October 24, 2016

Bill C-14, which sets out the legal framework for decriminalized euthanasia, satisfies no one. Some feel it is too restrictive. Others of us continue to have serious concerns about its implications.

We will all be vulnerable at some time in our lives and this legislation does not and cannot protect us. Even Justice Lynn Smith, the original Carter trial judge, foresaw the inevitability of wrongful deaths when the healthcare system provides state-sanctioned euthanasia. She suggested strong safeguards that should be “scrupulously enforced.” This bill does little toward establishing concrete guidelines, and life-ending decisions will be made for some patients against their explicit wishes as a result.

Here are some measures that may help to provide somewhat better protection for vulnerable patients.

First, proper care for patients with serious conditions is a basic human right and sufficient funding is essential. Currently, 70% of Canadians do not have access to adequate palliative care. This is a dismal failure for our healthcare system and an unacceptable tragedy. Canadians deserve better care — focused, excellent care that provides all the necessary supports to live life to the full, instead of a cold analysis that the person’s life is “not worth living” and a state-sanctioned system to deliver death instead of support.

Faye Sonier

Next, we must protect the conscience rights of physicians and other healthcare professionals. Thousands of citizens, who pay into our healthcare systems, want nothing to do with any form of hastened death. They have the right to be treated by professionals and in facilities where caring never includes killing. Real patient choice, “patient-centered care” and cultural diversity should mandate that our system accommodates many different demographic groups, including completely euthanasia-free healthcare facilities for those who need such settings to feel and to be safe. The assertion that it is “cruel” to move a patient to a different ward within a hospital or an outside facility that has special expertise in providing euthanasia or assisted suicide is a complete red herring. Patients who are extremely sick are moved all the time without major discomfort — within the hospital, from hospital to home or hospice, or from one hospital to another for specialized imaging or daily radiotherapy treatments. How ludicrous that there is an outcry against moving someone in a scheduled, safe way to a site with expertise in the procedure and yet no similar indignation when patients who are in far worse condition languish in the hallways of emergency departments for days.

The provincial governments and physician regulatory bodies must take a strong stance in support of physician conscience rights. Unfortunately, the College of Physicians and Surgeons of Ontario released two anti-conscience rights policies which violate physician conscience rights. The policies are currently being challenged in court, and the Ontario government has intervened in support of the College. These policies are not only Draconian, but unnecessary. Patients should be able to self-refer to specialized agencies for any of these controversial procedures. Eliminating the requirement for a physician referral provides greater patient autonomy and privacy and streamlines the process. This agency could provide a team of expert assessors who would screen patients with a wish for euthanasia or assisted suicide, to offer help for any untreated symptoms and who would address deficits in the social determinants of health such as inadequate support or loneliness. This system would be better for patients and obviate the need for any physician with conscientious objections to participate.

In addition, we must ensure robust data collection and oversight of euthanasia and assisted suicide reporting procedures. In the jurisdictions that have decriminalized these procedures, including Canada, not a single country has instituted an independent body to oversee those performing the acts. The physicians who write the prescription for assisted suicide drugs or administer the euthanasia drugs themselves are the ones who fill out the death certificates.

Studies have shown that means other than proper euthanasia protocols are used when doctors cannot be bothered to fill out the paperwork. In Belgium, where the legal framework is strikingly similar to Canada’s, studies have documented that up to 32% of all euthanasia procedures have been performed without the patient’s express consent. Another study found that around 47% of euthanasia deaths in a given year went unreported. In Quebec, which passed a voluntary euthanasia law in December 2015, physicians who perform euthanasia cannot record “medical assistance to die” as the cause of death on the death certificate, but must list instead the name of the condition affecting the patient that led the patient to request euthanasia.

Those in favour of these procedures continue to assure Canadians that these measures will only be for “hard cases,” and the public has believed this. However, there are already very credible reports of cases that fall well outside the legislation’s mandate that should cause concern and trigger more careful surveillance. We owe it to ourselves to keep careful, detailed records about the type of patients who are having their deaths hastened and for what reasons. Our strong support of suicide prevention must extend to this vulnerable population as well.

Wrongful and unnecessary deaths will occur. We can and should institute these basic measures to try to limit the damage, to begin to protect patients and to preserve real choice.

Margaret Cottle, MD, CCFP (Palliative Care) is a palliative care physician in Vancouver, BC, a Clinical Assistant Professor at the University of BC and the former VP of the Euthanasia Prevention Coalition. Faye Sonier is Canadian Physicians for Life’s Executive Director and General Legal Counsel.

“As soon as this law was passed — and you see it everywhere, when these laws are passed — patients fighting for a longer life end up getting denied treatment, because this will always be the cheapest option,”

Attitude have also changed in her support group:

After the right-to-die movement began garnering national attention, Mrs. Packer said she noticed a change in tone at her support groups for terminally ill patients. While the meetings were formerly positive and encouraging, she said the specter of suicide now hangs above them like a dark cloud.

“And people, once they became depressed, it became negative, and it started consuming people,” she said in the video. “And then they said, ‘You know what? I wish I could just end it.’ “

Stephanie Parker is not the first person to be denied chemotherapy but offered assisted suicide. Several years ago Barbara Wagner and Randy Stroup, in Oregon, were denied medical treatment but offered assisted suicide.

In the 2014-2015 period, the report says, 124 of the 3,950 euthanasia cases in Belgium involved persons diagnosed with a “mental and behavioral disorder,” four more than in the previous two years. Tiny Belgium’s population is 11.4 million; 124 euthanasias over two years there is the equivalent of about 3,500 in the United States.

The figure represents 3.1 percent of all 2014-2015 euthanasia cases — and a remarkable 20.8 percent of the (also remarkable) 594 non-terminal patients to whom Belgian doctors administered lethal injections in that period.

Order the Euthanasia Deception documentary, featuring Belgian people with personal experience with euthanasia and assisted suicide. One of the interviews concerns a man whose depressed mother died by euthanasia.

Lane points out that the Belgian euthanasia is now being criticized:

Recent newspaper articles and documentaries focused on cases in which psychiatrists euthanized or offered to euthanize people with mental illnesses, some still in their 20s or 30s, under dubious circumstances.

Seemingly stung by these criticisms, the commission spends two of its report’s pages defending the system, explaining that all is well and that no one is being euthanized except in strict accordance with the law.

Wim Distelmans, who is the chair of the Belgian Federal Commission on the Control and Evaluation of Euthanasia defends the Belgian law, but Distelmans is also the doctor who operates a euthanasia clinic that is responsible for a large percentage of the euthanasia deaths for psychiatric reasons. Lane writes:

In particular, the regulatory panel — chaired by Wim Distelmans, a leading proponent of euthanasia who conducts the procedure himself — defends the one-month waiting period required between the time a mentally ill or otherwise cognitively impaired person puts his or her signature on a written request for death, and the time it may be carried out.

Objections that this is too little time are “unfounded,” the report asserts, because “the formation of the true will of the patient is a long process that takes several months, sometimes years,” then culminates in the written request. In any case, the waiting time is often longer in practice.

Lane counters Distelmans defense of psychiatric euthanasia by quoting from opponents of the practise:

“We see that some who were first declared incurable, eventually abandon euthanasia because new prospects showed up. In a paradoxical way, this proves that the disease can not be called incurable.”

This, regarding a Belgian medical system that over the past two years administered lethal injections upon the request of five non-terminally ill people with schizophrenia, five with autism, eight with bipolar disorder and 29 with dementia — an increasingly common condition in the aging Western world — as well as 39 with depression, according to the report.

As a father of a adult autistic son, I find this data very disturbing.

Lane continues by stating that the American Psychiatric Association a declaration that it is unethical for any psychiatrist to participate in the euthanasia of people who are not terminally ill and the World Psychiatric Association, which has a position discouraging participation in euthanasia of people who are not terminally ill, will revisit the issue in 2017.

Sadly, the new Canadian euthanasia law permits euthanasia for people who are living with physical or psychological suffering.

Last night the mover of the Voluntary Euthanasia Bill 2016, Steph Key gave a rather cryptic comment to the South Australian media about the possible adoption of their 'plan b'.

It is not a stretch to observe that one only goes to a 'plan b' if 'plan a' - the existing bill, is not going to pass muster.

This was a clear admission from Steph Key that she and her team were not confident that her bill would pass at the Second Reading vote scheduled for this Thursday the 20th of October.So what does 'plan b' look like?

Readers will recall that, after the Voluntary Euthanasia Bill 2016 had been in the chamber for something like eight months, Steph Key recently tabled a set of her own amendments to her own bill that she had hoped would convince MPs who were rightly concerned about the Belgian style model in the current bill, to allow the bill to pass on Thursday so that these amendments could be discussed and the bill modified.

This 'eleventh hour' amendment schedule (less that a week from the scheduled debate) as the Australian Medical Association observed, ran to thirteen pages - only a few pages short of the length of the bill itself. Parliamentarians and the public will have had little time to scrutinise the changes, which can only have added to the cynicism amongst Key's parliamentary colleagues.

Key clearly expected her colleagues to pass a very dangerous bill on the possibility that the amendments she foreshadowed would be adopted during the debate on clauses that would have followed. That is never certain. This is reckless and MPs clearly agreed in the majority.

We now understand that a new bill will be introduced today that is essentially the old bill with the flagged amendments incorporated.

I can understand that with everything invested in what must be said was a comprehensive campaign in support of the bill, that to lose on Thursday was not something that Key and her allies wanted to face. Regardless, much of that impetus is now lost as the debate begins again. Key's colleague Duncan McFetridge MP announced the tabling of this new bill in his name. He said that he hoped to have the matter 'approved in about a month'. The Advertiser story repeated the false claim that, 'A request for voluntary euthanasia would not be granted if there was another medical treatment or palliative care option that would relieve the person’s suffering.'

In normal circumstances, this 'new' bill would progress at a snails pace like all private member's bills. That would normally mean that the debate in earnest would probably not occur until the second half of 2017 - when MPs are beginning to focus on the March 2018 election. But these are not necessarily normal times and one can bet that Steph Key will be pressuring the Premier for special treatment. Originally the Premier had signaled that he wanted the issue out of the way by Christmas. It remains to be seen if that commitment extends to this new bill.

One hopes that MPs will remain cynical that Steph Key and her cohort have essentially used the parliament as something of a private play thing. Many MPs will have private members business of their own that they would also dearly love to progress.

While the old bill would have made the state the 'Belgium of the South', the new bill is closer to the Oregon model but with some curious additions. Like its predecessor, it will fail to protect people. Only a total ban on euthanasia & assisted suicide can achieve that.

According to an expert on the issue, once euthanasia is legalized it becomes a natural trend – and he cites astonishing numbers from a European country to support his argument.

The latest figures from Switzerland (from 2014) show assisted suicide deaths are up 26 percent from 2013 – and more than 2.5 times as many as five years previously. The Swiss suicide clinic "The Exit" reported a 34-percent increase in business for 2015, while deaths from the other Swiss suicide clinics remain unknown.

"This is a worldwide phenomenon. Every time you legalize euthanasia, the numbers only go up every year," says Alex Schadenberg with the Euthanasia Prevention Coalition, "because there's more and more reasons why people now say I want to die – and there's more and more people willing to do it for more and more conditions. That's what we see in the Netherlands, and that's what we're seeing in Switzerland."

Recent examples in Switzerland include a 62-year-old magistrate killed, but whose autopsy revealed an incorrect diagnosis; and an 85-year-old woman who was euthanized because she didn't like her appearance.

Schadenberg explains that for many individuals, euthanasia is becoming "the answer" for loneliness and depression – resulting in a "ridiculous situation."

"... When you've got a culture that kills its most vulnerable who are lonely or going through a time in their life when they really need others ... this is what it's coming down to," he laments. "Even in Oregon and Washington state they can say what they want, but their numbers have gone up every year in the last few years."

Tuesday, October 18, 2016

California has promulgated a regulation to assure that the mentally ill who have been ordered hospitalized in California have access to assisted suicide if they are dying and deemed able to make medical decisions. From 9 California Code of Regulations § 4601 (my emphases):

(a) A terminally ill patient, as defined by the End of Life Option Act, may petition the superior court for access to participate in activities under the End of Life Option Act by requesting release from the custody of the Department of State Hospitals from the court. If the court orders release from the custody of the Department of State Hospitals, the Department of State Hospitals shall release the patient to the ordered entity or person.

People can be involuntarily hospitalized for psychiatric reasons in CA if they are found by a court, beyond a reasonable doubt, to be a danger to themselves or others.

Thus, if a suicidal patient requests to be released to commit suicide but isn’t terminally ill, he will be refused if he is still considered a mortal danger to himself. But if the same patient has terminal cancer, he must be released in order to commit suicide.

That’s not only nuts, but the state is abandoning the terminally ill with mental illnesses to their darkest impulses.

And what if a court decides the patient is, say, too dangerous to be let out? The state must facilitate the suicide by either transporting the mentally ill patient to a death locale or see the deed done at the state facility:

If a court orders that the patient meets the qualifications under the End of Life Option Act, and that the Department of State Hospitals shall facilitate the patient’s access to participate in activities under the End of Life Option Act, the Department of State Hospitals will facilitate the patient’s access to an off-site facility that allows the patient the ability to participate in activities under the End of Life Option Act….

1) If the court orders that the patient meets the qualifications under the End of Life Option Act, and the Department of State Hospitals is unable to find an off-site facility for the patient to participate in activities under the End of Life Option Act, the Department of State Hospitals will facilitate the patient’s ability to participate in activities under the End of Life Option Act on-site.

Think about this. There will be patients forcibly hospitalized in these institutions because they are suicidal, who will know that other patients are being assisted in suicide. The mind just boggles!

But it’s not unexpected. In Oregon, Michael Freeland was lethally prescribed (two years before dying naturally). Before getting around to killing himself, he became psychotic and was forcibly hospitalized. His psychiatrist made sure his guns were taken but also that the poison prescription “remained safely at home,” even though he would “experience periods of delirium,” the shrink wrote in Freeland’s medical records.

Abuses of assisted suicide in Oregon, Wesley? What abuses?

To recap: My state, which may soon do away with the death penalty, specifically will require government participation and facilitation of the suicides of mentally ill people if they have been diagnosed with a terminal illness.

This so-called “death with dignity” movement is driving us out of our collective minds.

The Colorado Springs Gazette is urging Colorado citizens to vote no on the assisted suicide Proposition 106. In its recent summary of Gazette endorsements, the paper stated:

Out-of-state billionaire George Soros wants to impose this irresponsible law on Colorado as another of his infamous arms-length social experiments. It is a badly written law that will come with unthinkable consequences. Colorado's suicide rate is already too high and rising, especially among teens. This sends the wrong message. But it's worse than that. The law could facilitate impatient heirs in coercing the early deaths of relatives, friends and business partners. It shields from accountability anyone who witnesses a suicide. A similar law in Oregon has greedy insurance companies encouraging suicides to save the costs of treatments and cures. We don't need more suicide, much less a law that allows for almost anything-goes assisted suicide.

Writing to the parliament this week, Lives Worth Living made some keen observations:

We note that there have been significant amendments to the Bill which attempt to remove some issues but there are still considerable areas of concern to us.

This is now to some extent a new Bill and this warrants consultation. Lack of consultation with the disability community on euthanasia is an ongoing concern.

The Bill does not name the disabilities or conditions covered or exclude any disabilities, illnesses or chronic conditions instead focusing on how the condition is experienced and perceived.

This Bill does not define a terminal medical condition and imagines that you can make a clear distinction between a person with a medical condition and a person “suffering from a disability”. Most disabilities shorten the lifespan and there is no clearly defined boundary between a shortened life span and a terminal illness.

The attempt to excise disability in section 10 is welcome but is actually ineffectual and this is apparent in the way it is framed i.e, “a person is not an eligible person merely because the person is … suffering from a disability (however described).

All people with disability have medical conditions that cause a disability, meaning that disability is in scope at the outset. The disability arising from a condition is caused by a lack of access to rights, access, treatments and disability. The Bill misunderstands this on a basic level.

LWL canvasses an alternative:

We would prefer that the South Australian Parliament addressed secondary comorbidity, barriers and lack of supports experienced by people with a disability rather than provide a mechanism for suicide because of them. Instead of safeguards, we need to be talking about preconditions. Like the precondition that half of us no longer live in poverty, have good access to medical treatment and palliative care, that we have the care and support to live a good life.

And suicide prevention rather than enabling:

LWL is concerned that the Bill creates a double standard in the treatment and interventions around ending one’s life based on disability. Euthanasia is assisted suicide and as we read it the Bill it fails to mandate suicide prevention and other counselling which may identify other issues in people’s lives which weigh in their decisions. Where counselling is addressed it is an option for the primary practitioner, not mandated. For any other group in the community – young people, LGBTIQ people, indigenous people – we do everything we can to avert suicide. Where are the suicide interventions for people with disability?

The letter goes on to outline some of the difficulties people with a disability encounter when engaging with the medical profession. Difficulties that create or exacerbate concerns about legalised euthanasia and assisted suicide.

We are not satisfied with decision making and safeguards by medical practitioner around euthanasia as outlined in Section 11.

Many people with long term disabilities have endured a string of negative interactions with medical practitioners who underestimate the life chances, value and worth of people with disability;

This occurs for a reason. Disability advocates operate from a social model of disability which assumes that barriers in the community should be addressed, whereas the medical model assumes we are the problem.

Medical interventions are different from disability supports and in some cases people require advocacy against medical interventions or decisions. Doctors with the best of intentions are often unaware of disability supports, interventions and advocacy that make a person’s life liveable rather than just trying to cure a person’s underlying disease; and crucially

The Bill does not even mention disability supports or advocacy.

LWL closes by calling on the parliament to reject the bill:

LWL believes that the Bill as it stands raises serious risks for people with disability and we hope it is defeated in the Parliament of South Australia. We are also releasing this letter publicly to contribute to community debate.

The release of the LWL letter is timely, given that disability activists from across Australia will be fronting the media and providing a briefing for parliamentarians this week ahead of the debate on the 20th of October.

The event was bolstered by a video presentation from UK actress, disability activist, comedian and braodcaster, Liz Carr directed at all members of parliaments in Australia.

This spring, a patient told Dr. Ramona Coelho she was thinking about physician-assisted death.

Coelho gently probed to find out what was at the heart of the woman’s fear, anxiety and depression. The patient felt her life was diminished and no longer meaningful. Coelho says she steered the patient away from assisted death to finding ways to make every day seem worthwhile.

“My patients’ death wishes go away when their issues are dealt with,” says Coelho, who has practised medicine since 2007 and did palliative-care work in Montreal before moving to London, Ont., in 2012. She believes time, careful listening, affection and respect are key to a good relationship with patients.

“We have a rushed, overworked health-care system. Patients feel neglected. It can create an overwhelming anxiety. What is driving a lot of death wishes is anxiety. It’s not overwhelming pain.”

Coelho was interested in social justice long before she went to medical school. And yet she is surprised to be considered a “conscientious objector” to assisted death.

“I’m just trying to live by my conscience and with integrity,” she says.

A College of Physicians and Surgeons of Ontario policy acknowledges that physicians who object to providing medical assistance in dying for reasons of conscience or religion are not required to provide that assistance or assess whether a patient is eligible. However, these conscientious objectors must provide “an effective referral” to a patient in a timely manner. That means a referral made in good faith, to a non-objecting, available and accessible physician, nurse practitioner or agency.

This “active” referral is the sticking point for physicians like Coelho, who believe the province should set up a self-referral phone line for patients and not require physicians to act against their conscience.

“Patients want to know, ‘What would you do if you were me?’ So why would I offer them something if I feel it would be bad for them?” she says.

If a patient insisted on seeking access to assisting dying, Coelho says, she would respectfully ask that patient to find other means.

“They could still see me for emotional support. I truly have affection for people I disagree with. I wouldn’t terminate the relationship. The important thing is that we don’t abandon a patient. But you don’t have to do something that’s against your conscience.”

Coelho doesn’t want to bring religion into it. Assisted death has been a polarizing issue, and neither side is open to debate. Talking about religion creates a bias about the person making an argument, she says.

“If I brought religion into it, people would try to put me in a box and explain me away.”

The College of Physicians and Surgeons of Ontario has had no discipline cases for access to medically assisted dying, a spokeswoman says.

“In the event that we receive a complaint from the public relating to the provision of medical assistance in dying, we will investigate just as we would when a concern is raised about any other area of medical practice.”

Coelho recognizes speaking to a reporter about referring patients puts her viewpoint “out there.” But at the end of the day, a patient is free to see another doctor, she says.

“I respect free will. I can’t control people. I’m passively objecting. This law stands, unfortunately. But I shouldn’t be forced to do it. There’s a thousand other medical acts I can do. And I do them well.”

Friday, October 14, 2016

The death of a terminally ill seventeen-year-old boy made headlines recently, as Belgium’s first case of child euthanasia. I don’t understand the sudden fuss. The Netherlands has long allowed minors to request and receive euthanasia: Dutch children down to age sixteen can receive euthanasia without their parents’ consent, and children can be killed by doctors with parental consent starting at age twelve.

Perhaps Belgium’s euthanasia law has received this recent media attention because it has no age limits, instead requiring that a minor demonstrate a capacity to make autonomous decisions before receiving assisted suicide.

Think about this: Children who can’t enter into legal contracts, get tattooed, or be licensed to drive a car may request—and receive—death.

The healthcare system doesn’t dole out death only to teens and preteens. In the Netherlands, doctors commit infanticide against babies born with serious disabilities or terminal illnesses with impunity, even though the practice remains technically illegal. Indeed, doctors at the Groningen University Medical Center felt so safe committing infanticide that they published the Groningen Protocol, a bureaucratic checklist to help determine whether a baby is killable.

The protocol permits doctors to administer lethal injections to infants under three scenarios:

the baby has no chance of survival (a circumstance that is sometimes misdiagnosed);

the baby “may survive after a period of intensive treatment but expectations for their future are very grim”;

the baby does “not depend on technology for physiologic stability” but has “suffering [that] is severe, sustained, and cannot be alleviated.”

This means that doctors are lethally injecting not only babies who are dying, but also babies with serious disabilities who do not need intensive care—those who are living what is sometimes called an “unlivable life” by Dutch infanticide apologists. The Groningen Protocol was published without criticism in the New England Journal of Medicine.

But babies don’t have decisional capacity. Thus, in order to maintain the pretense that euthanasia is about “choice,” the protocol requires parental consent. That, however, opens the door to all kinds of horrors. One can easily envision parents deciding that they would be better off without a disabled child for whom they would have to provide ongoing care. After all, such decisions are ubiquitous involving later-term abortions of fetuses diagnosed with Down syndrome and other disabilities. Moreover, according to a study published in The Lancet in 1997—admittedly, before the protocol was crafted—some 21 percent of babies killed by doctors responding to the authors’ questionnaires had been euthanized without parental consent.

I guess we should be pleased that the euthanasia death of a seventeen-year-old remains at least mildly controversial. But it is clear that the culture of death, if allowed to progress further, will eventually consider such deaths routine. That is why I was completely unsurprised that Princeton University’s Peter Singer, who believes it should be acceptable kill babies because (in his view) they are not “persons,” came to the Belgian law’s defense.

Singer assures us that the law “effectively excludes very small children.” But why would the age of the euthanized be of any significance to Singer, given that he supports not only infanticide but also the non-voluntary euthanasia of adults who have lost decisional capacity? Moreover, Singer believesthat children do not attain “full moral status” until “after two years” of age—implying they too could be killed, although he is too politically savvy to support such a public policy.

Singer also grapples—poorly—with the fact that children he thinks should be allowed to choose to die can’t make other adult decisions:

Age limits are always to some extent arbitrary. Chronological age and mental age can diverge. For some activities for which a mental age limit may be relevant, the number of people engaging in the activity is very large: voting, obtaining a driving license, and having sex, for example. But it would be very costly to scrutinize whether every person interested in those activities has the capacity to understand what is involved in voting, driving responsibly, or giving informed consent to sex. That is why we rely on chronological age as a rough indication of the relevant mental capacity.This is not true of minors requesting euthanasia. If the number of those who meet the requirements of the law is so small that Belgium has had only one case over the past two years, it is not difficult to carry out a thorough examination of these patients’ capacities to make such a request.

Please. There are plenty of minors who could be shown in court to have the decision-making capacity that allows Belgian youngsters to receive death, and yet who are still considered rape victims when they have consensual sex with an adult. The issue isn’t the cost or difficulty of measuring maturity, but the defining need to protect all minors from harmful choices.

Here’s the bottom line. Euthanasia consciousness isn’t really about “choice.” Nor is it about terminal illness. Rather, euthanasia proponents see killing and suicide as acceptable answers to human suffering and acceptable means of reducing costs of care. Publicizing the euthanasia of a seventeen-year-old marks the beginning of a campaign to normalize putting dying (and eventually disabled) children to sleep.

Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism and a consultant to the Patients Rights Council. His new book Culture of Death: The Age of “Do Harm” Medicine was just published by Encounter Books.